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Mahé G, Boge G, Bura-Rivière A, Chakfé N, Constans J, Goueffic Y, Lacroix P, Le Hello C, Pernod G, Perez-Martin A, Picquet J, Sprynger M. Update About the Management of Low-Density Lipoprotein Cholesterol and Hypertriglyceridemia in Lower Extremity Peripheral Artery Disease Patients: Consensus of the French Society of Vascular Medicine and the French Society for Vascular and Endovascular Surgery. Ann Vasc Surg 2024; 100:148-154. [PMID: 37806655 DOI: 10.1016/j.avsg.2023.08.023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2023] [Revised: 08/09/2023] [Accepted: 08/10/2023] [Indexed: 10/10/2023]
Abstract
BACKGROUND A French intersociety consensus on behalf the Société Française de Médecine Vasculaire and the Société de Chirurgie Vasculaire et Endovasculaire was proposed in 2021 for the management of patients with lower extremity peripheral artery disease (LEAD). Recent studies have been published and an update of this consensus about the management of low-density lipoprotein cholesterol (LDLc) and hypertriglyceridemia was required. METHODS A steering committee of 12 vascular physicians and surgeons defined questions of interest about LDLc and hypertriglyceridemia management. A French expert panel voted the proposals. Consensus was considered to have been achieved if more than 80% of the responses corresponded to either "Agreement" or "Disagreement". RESULTS Among the 56 experts who were asked to participate, 46 (82%) accepted. After the first round of the Delphi procedure, the 4 proposals reached consensus. The following suggestions and recommendations were approved: 1. For LEAD patients treated by the highest tolerated statin dose ± ezetimibe and who have an LDLc ≥0.70 g/L, we recommend adding a proprotein convertase subtilisin/kexin type 9 inhibitor. 2. For LEAD patients treated by statin and who have elevated triglyceride level between ≥150 mg/dL and ≤500 mg/dL, we suggest adding Icosapent Ethyl. 3. Before adding Icosapent Ethyl in LEAD patients treated with statin, we suggest looking for symptoms that may suggest atrial fibrillation. 4. For LEAD patients treated by Icosapent Ethyl and who have symptoms that suggest atrial fibrillation, we recommend performing an electrocardiogram. CONCLUSIONS This update will help clinicians to improve LEAD patient management.
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Affiliation(s)
- Guillaume Mahé
- Vascular Medicine Department, Radiology and Medical Imaging Department, Rennes University Hospital Centre, Rennes, France.
| | - Gudrun Boge
- Vascular Medicine Department, Montpellier University Hospital Centre, Montpellier, France
| | - Alessandra Bura-Rivière
- Vascular Medicine Department, Toulouse University Hospital Centre, Rangueil Hospital, Toulouse, France
| | - Nabil Chakfé
- Vascular Surgery and Kidney Transplantation Department, Strasbourg University Hospital Centre, Strasbourg, France
| | - Joël Constans
- Vascular Medicine Department, Bordeaux University Hospital Centre, Saint André Hospital, Bordeaux, France
| | - Yann Goueffic
- Vascular Surgery Department, Saint-Joseph Paris Hospital Group, Paris, France
| | - Philippe Lacroix
- Vascular Medicine Department, Limoges University Hospital Centre, Limoges, France
| | - Claire Le Hello
- Vascular Medicine Department, Saint-Etienne University Hospital, Saint-Etienne, France
| | - Gilles Pernod
- Vascular Medicine Department, Grenoble University Hospital Centre, Grenoble, France
| | - Antonia Perez-Martin
- Vascular Investigation and Vascular Medicine Department, Nimes University Hospital Centre, Nimes, France
| | - Jean Picquet
- Vascular and Thoracic Surgery Department, Angers University Hospital Centre, Angers, France
| | - Muriel Sprynger
- Cardiology Department, Sart Tilman University Hospital Centre, Liège, Belgium
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Vecchini F, Haupert G, Baudry A, Mancini J, Dumur L, Martinez R, Piquet P, Picquet J, Gaudry M. Risk Factors for Incomplete Aortic Remodeling With Stent-Assisted Balloon-Induced Intimal Disruption and Relamination in Aortic Dissection Repair for Complicated Aortic Dissection: Results of a Multicenter Study. J Endovasc Ther 2024; 31:69-79. [PMID: 35880296 DOI: 10.1177/15266028221111984] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
PURPOSE The STABILISE technique has extended the treatment of aortic dissection to the thoracoabdominal aorta to achieve complete aortic remodeling. The aim of this multicenter study was to analyze the short- and midterm anatomical results of the STABILISE technique. MATERIALS AND METHODS We retrospectively analyzed patients treated with the STABILISE technique for complicated aortic dissection at 3 French academic centers. The aortic diameter at different levels was measured preoperatively, postoperatively, and at 1 year. RESULTS Between 2018 and 2020, 58 patients, including 47 men (average patient age: 60±11 years), were treated for type B aortic dissection in 34 cases and residual aortic dissection after type A repair in 24 cases. Three (5.2%) patients died postoperatively. Complete aortic remodeling (false lumen thrombosis and complete reapposition of the intimal flap) was achieved in 45/55 patients (81.8%), and false lumen thrombosis in the thoracic aorta was achieved in 52/55 patients (94.5%). At 1 year, with a computed tomographic (CT) scan available for 98.2% (54/55) of patients, we observed a significant decrease in the maximal thoracic aortic diameter and a significant increase in the aortic diameter at the bare-stent level compared with the preoperative CT scan. Severe aortic angulation (p=0.024) was a risk factor for incomplete aortic remodeling and significantly increased the aortic diameter (p=0.032). Chronic aortic dissection was associated with an increased risk of incomplete aortic remodeling (p=0.002). CONCLUSIONS STABILISE for complicated aortic dissection results in false lumen thrombosis, complete reapposition of the intimal flap, and a decrease in the maximum aortic diameter in most cases. Incomplete reapposition of the intimal flap, which is more frequent in cases of chronic aortic dissection and severe aortic angulation, is a risk factor for a significant increase in the aortic diameter at the bare-stent level, and this risk justifies close follow-up and better patient selection. CLINICAL IMPACT STABILISE technique for complicated aortic dissection results in false lumen thrombosis, complete aortic remodeling and a decrease in the maximum aortic diameter in most cases. At the bare-stent level, incomplete reapposition of the intimal flap, more frequent in chronic aortic dissection and severe aortic angulation, is a risk factor for an increased aortic diameter. This finding justifies close follow-up and better patient selection; thus, the STABILISE technique should be used with care in chronic aortic dissection and severe aortic angulation.
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Affiliation(s)
- Fabien Vecchini
- Department of Vascular Surgery, APHM, Timone Hospital, Marseille, France
- Aortic Center, APHM, Timone Hospital, Marseille, France
| | - Gautier Haupert
- Department of Vascular Surgery, Tours Academic Center, Tours, France
| | - Anna Baudry
- Department of Vascular Surgery, Angers Academic Center, Angers, France
| | - Julien Mancini
- APHM, INSERM, IRD Biostatistics Department, SESSTIM, BIOSTIC, Aix-Marseille University, Marseille, France
| | - Lucie Dumur
- Department of Vascular Surgery, Tours Academic Center, Tours, France
| | - Robert Martinez
- Department of Vascular Surgery, Tours Academic Center, Tours, France
| | - Philippe Piquet
- Department of Vascular Surgery, APHM, Timone Hospital, Marseille, France
- Aortic Center, APHM, Timone Hospital, Marseille, France
| | - Jean Picquet
- Department of Vascular Surgery, Angers Academic Center, Angers, France
| | - Marine Gaudry
- Department of Vascular Surgery, APHM, Timone Hospital, Marseille, France
- Aortic Center, APHM, Timone Hospital, Marseille, France
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Deveze E, Bruneau A, Raimondeau D, Henni S, Abraham P, Picquet J. Long-Term Functional Outcomes After Surgery of Functional Popliteal Artery Entrapment Syndrome. Ann Vasc Surg 2023; 97:405-409. [PMID: 37244483 DOI: 10.1016/j.avsg.2023.05.021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2023] [Revised: 05/14/2023] [Accepted: 05/16/2023] [Indexed: 05/29/2023]
Abstract
BACKGROUND Functional popliteal artery entrapment syndrome (fPAES) is a subtype of PAES without anatomic abnormalities entrapment of the popliteal artery. One of the management of symptomatic fPAES is surgical exploration of the popliteal region with popliteal artery release with lysis of fibrous bands. There is a lack of data regarding the long-term functional results of this surgery, most of the studies focusing on vascular patency in anatomical PAES. The aim of this study was to assess the efficacy of surgery in functional PAES, focusing on long-term physical activity return after surgery with the Tegner activity scale. METHODS All patients who underwent surgery for fPAES from January 1, 2010, to December 31, 2020, were searched. After ethical approval, all patients were called to evaluate physical activity since surgery. The Tegner activity scale is a numerical scale with each value (0 to 10) representing specific activity. The aim was to evaluate everyday activity limitations and participation restriction after surgery. The results for each patient were recorded: "before symptoms," "before surgery," and "after surgery." RESULTS Over the study period, 33 patients were included with 61 symptomatic legs. The mean time between surgery and phone call was 38.6 ± 21.9 months. The median score of the Tegner activity scale "before symptoms" was 7 (4-7), the median score "before surgery" was 3 (2-3), and the median score at the time of the phone call "after surgery" was 5 (3-7). P value was <0.0001 by comparing results "before surgery" and "after surgery." CONCLUSIONS Results demonstrated that the sport activity and intensity level is significantly higher after surgery even if patients did not reach their initial sport activity level.
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Affiliation(s)
- Eva Deveze
- Vascular and Thoracic Surgery, University Hospital, Angers, France.
| | | | | | - Samir Henni
- Vascular Medicine, University Hospital, Angers, France; UMR CNRS 1083 INSERM 6214, LUNAM University, Angers, France
| | - Pierre Abraham
- Vascular Medicine, University Hospital, Angers, France; UMR CNRS 1083 INSERM 6214, LUNAM University, Angers, France
| | - Jean Picquet
- Vascular Medicine, University Hospital, Angers, France; UMR CNRS 1083 INSERM 6214, LUNAM University, Angers, France
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Deveze E, Ammi M, Hersant J, Papon X, Henni S, Abraham P, Picquet J. Ten-year Experience of Surgical Management of Paget-Schroetter Syndrome. Ann Vasc Surg 2023; 96:328-334. [PMID: 37023925 DOI: 10.1016/j.avsg.2023.03.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2022] [Revised: 03/03/2023] [Accepted: 03/12/2023] [Indexed: 04/08/2023]
Abstract
BACKGROUND Paget-Schroetter syndrome (PSS) or effort-induced thrombosis is an acute (<14 days) venous thrombosis of the axillosubclavian vein. Early catheter-directed thrombolysis (CDT) is required to improve patency rate and avoid postthrombotic syndrome. This study aimed to report the management of PSS in our center across 10 years and compare it to the established guidelines. METHODS Some of the selected patients were treated with CDT if the diagnosis of acute vein thrombosis was established 6 weeks after the appearance of the first symptoms and if a vascular surgeon was involved in the care and management of the patient. Patients underwent first rib removal 6 weeks after the CDT. Some patients with primary upper limb venous thrombosis were not immediately referred to a vascular surgeon after the initial diagnosis. They were instead discharged home with the prescription of oral anticoagulation therapy (OAT) alone for at least 3 months. RESULTS Between 2010 and 2020, 426 first rib removal procedures were performed for 338 patients with thoracic outlet syndrome (TOS) at our center. Among them, 18 (4.2%) patients with PSS were identified. 5 (27.8%) patients underwent CDT. The median duration between first symptoms and thrombolysis was 10 days (range, 1-32). Thirteen (72.2%) patients were discharged home with OAT alone and referred to a vascular surgeon with a median time of 365 days (range, 8-6,422) for TOS diagnosis. Postthrombotic syndrome was noticed in 5 (38%) patients in the OAT group and 1 (20%) patient in the CDT group. CONCLUSIONS Despite the guidelines being in favor of early CDT in PSS, most patients are discharged home with OAT alone. The study findings demonstrate that better information about this specific complication must be provided to the concerned practitioners who are likely to encounter such patients.
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Affiliation(s)
- Eva Deveze
- Vascular and Thoracic Surgery, University Hospital, Angers, France.
| | - Myriam Ammi
- Vascular and Thoracic Surgery, University Hospital, Angers, France
| | | | - Xavier Papon
- Vascular and Thoracic Surgery, University Hospital, Angers, France
| | - Samir Henni
- Vascular Medicine, University Hospital, Angers, France
| | - Pierre Abraham
- Vascular Medicine, University Hospital, Angers, France; UMR CNRS6015-INSERM-1083, Mitovasc Institute, University of Angers, Angers, France
| | - Jean Picquet
- Vascular and Thoracic Surgery, University Hospital, Angers, France
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Alkhani MA, Picquet J, Chaufour X, Bartoli M, Feugier P. The Effect of the COVID-19 Crisis on Vascular Surgery Training in France. Cureus 2023; 15:e40863. [PMID: 37489197 PMCID: PMC10363397 DOI: 10.7759/cureus.40863] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/23/2023] [Indexed: 07/26/2023] Open
Abstract
In France, since March 2020, the healthcare system has experienced a significant decrease or even suspension of surgical activity and admissions due to the coronavirus disease 2019 (COVID-19). This activity is essential to the acquisition of technical skills for all trainees enrolled in the Vascular and Endovascular Surgery Training Program either as residents or fellows. The crisis may have affected the training of vascular surgery trainees. We describe the consequences and effects of the COVID-19 crisis on the training of vascular surgery trainees. A cross-sectional study using an anonymous survey of 12 items was sent to all surgeons in training, registered at the French College of Vascular and Endovascular Surgery (CFCVE). Responses were collected between July and November 2021. Fifty-two responses were collected from trainees (residents=48%; fellows=52%), seven of who contracted COVID-19 disease. The crisis affected their scheduled and emergency surgical activities, in 96% and 77%, respectively. Thirty-one percent of responders stopped all activity, for an average of 1.5 months. Eighteen percent of responders were reassigned to other services (emergency department, ICU, vascular access unit, etc...) for an average duration of two months. Sixty-seven percent of responders believe that their level of surgical training was affected due to the crisis. Fifty-six percent of responders do not think they have achieved their training objectives (55% for fellows, 65% for senior vascular surgery residents (4th, 5th, and 6th year), and 92% for junior vascular surgery residents (year 1, 2, and 3), contributing that to the COVID-19 crisis and its effect on the flow of patients during the crisis. Additional training time (> 3 months) and the utilization of simulation training to reduce the gap produced by the COVID-19 crisis were favored in 60% and 73% of cases respectively. The COVID-19 health crisis has affected the training of surgical trainees in vascular and endovascular surgery in France. Endovascular and vascular surgical French students in training are waiting now, for additional educational proposals, allowing them to make up for their lack of practice.
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Affiliation(s)
- Mohammed A Alkhani
- Vascular Surgery, French College of Vascular and Endovascular Surgery (CFCVE), Paris, FRA
- Vascular and Endovascular Surgery Unit, Hôpital Lyon Sud, Lyon, FRA
- Vascular and Endovascular Surgery, Claude Bernard University Lyon 1, Lyon, FRA
| | - Jean Picquet
- Vascular Surgery, French College of Vascular and Endovascular Surgery (CFCVE), Paris, FRA
- Vascular and Thoracic Surgery, Centre Hospitalier Universitaire Angers, Angers, FRA
| | - Xavier Chaufour
- Vascular Surgery, French College of Vascular and Endovascular Surgery (CFCVE), Paris, FRA
- Vascular and Endovascular Surgery, Toulouse University Hospital, Toulouse, FRA
| | - Michel Bartoli
- Vascular Surgery, French College of Vascular and Endovascular Surgery (CFCVE), Paris, FRA
- Vascular Surgery, Timone Aortic Center, Timone Hospital, Assistance Publique-Hôpitaux de Marseille, Marseille, FRA
| | - Patrick Feugier
- Vascular Surgery, French College of Vascular and Endovascular Surgery (CFCVE), Paris, FRA
- Vascular and Endovascular Surgery Unit, Hôpital Lyon Sud, Lyon, FRA
- Vascular and Endovascular Surgery, Claude Bernard University Lyon 1, Lyon, FRA
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Daligault M, Haupert G, Ammi M, Thouveny F, Enon B, Papon X, Picquet J. Transposition of the superior mesenteric artery associated with a left renal vein venous patch in the nutcracker syndrome: Experience of 11 cases in Angers. Ann Vasc Surg 2022. [DOI: 10.1016/j.avsg.2022.06.052] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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Deveze E, Papon X, Ammi M, Daligault M, Haupert G, Leplomb S, Picquet J. Doctor’s awareness of the Paget-Schroetter syndrome should be raised. Ann Vasc Surg 2022. [DOI: 10.1016/j.avsg.2022.06.049] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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Alkhani M, Chaufour X, Bartoli M, Picquet J, Feugier P. Effects of the medical crisis on surgical training. Ann Vasc Surg 2022. [DOI: 10.1016/j.avsg.2022.06.058] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Defay A, Deveze E, Picquet J, Daligault M. Interest of 3-D stereoscopic video to teach vascular surgical anatomy. Ann Vasc Surg 2022. [DOI: 10.1016/j.avsg.2022.06.060] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Deveze E, Bruneau A, Hersant J, Ammi M, Abraham P, Picquet J. Popliteal entrapment syndrome: diagnostic, surgical management and short-term results of a ten-year experience. Ann Vasc Surg 2022; 88:139-144. [PMID: 35810946 DOI: 10.1016/j.avsg.2022.06.017] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2022] [Revised: 06/16/2022] [Accepted: 06/22/2022] [Indexed: 11/18/2022]
Abstract
INTRODUCTION Popliteal artery entrapment syndrome (PAES) is a rare cause of lower limb claudication in young sportsperson without cardiovascular risk factor. We reported our diagnostic approach, surgical management and short term outcomes of this syndrome, over a 10-year period. MATERIAL AND METHOD Sportsperson with intermittent claudication systematically received color duplex ultrasonography with dynamic maneuvers in the sport medicine department. In case of PAES suspicion, diagnosis was confirmed by dynamic computed tomography or dynamic magnetic resonance angiography. Each patient was then evaluated by a vascular surgeon and surgery was performed. We retrospectively screened patients who underwent PAES surgery between 2010 and 2020 in the department of surgery in Angers university hospital. RESULTS Between January 2010 and December 2020, 38 patients with 67 symptomatic legs underwent surgery for PAES. Twenty three (60.5%) were men. The mean age at the time of surgery was 24.7 +/- 9 years. Clinical presentation was bilateral in 30 patients (81.1%). Duplex ultrasound demonstrated severe stenosis or occlusion in 45 legs (77%). When performed, CT-scan demonstrated popliteal artery compression in all cases (100%). According to Whelan and Rich classification, 36 patients (94.7%) had type 6 PAES. There was no mortality or severe complication after surgery. Morbidity included 4 post-operative hematoma (6%) and 8 prolonged healing (13%). The mean time of follow-up was 2.3 months +/- 1.2 months. After surgery, D-scan showed no signs of remaining popliteal artery compression in 92.5% of the case. Twelve patients (33.3%) were able to resume sport, 18 (50%) partially and 6 (16.6%) did not resume sport yet. CONCLUSION We report a cohort of 38 patients who underwent surgery for popliteal artery entrapment syndrome. Among them, 36 (94.7%) were functional PAES. Morbidity included 13% of prolonged healing. Two months follow-up demonstrated good results at dynamic D-scan without signs of remaining popliteal artery compression in 92.5% of the cases. These short-term results showed that one third of patients able to resume sport activity at initial level.
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Affiliation(s)
- Eva Deveze
- Department of Vascular Surgery, University Hospital of Angers, Angers, France.
| | - Antoine Bruneau
- Department of Sport Medicine, University Hospital of Angers, Angers, France
| | - Jeanne Hersant
- Department of Vascular Medicine, University Hospital of Angers, Angers, France
| | - Myriam Ammi
- Department of Vascular Surgery, University Hospital of Angers, Angers, France
| | - Pierre Abraham
- Department of Sport Medicine, University Hospital of Angers, Angers, France; Department of Vascular Medicine, University Hospital of Angers, Angers, France
| | - Jean Picquet
- Department of Vascular Surgery, University Hospital of Angers, Angers, France
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Ammi M, Hersant J, Henni S, Daligault M, Papon X, Abraham P, Picquet J. Evaluation Of Quality Of Life After Surgical Treatment Of Thoracic Outlet Syndrome. Ann Vasc Surg 2022; 85:276-283. [PMID: 35339598 DOI: 10.1016/j.avsg.2022.03.012] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2021] [Revised: 03/01/2022] [Accepted: 03/04/2022] [Indexed: 11/01/2022]
Abstract
BACKGROUND To evaluate the quality of life of surgically treated patients for TOS. METHODS A prospective observational study including patients treated surgically for TOS, on 2018. Two standardized questionnaires: Disability of the Arm, Shoulder, and Hand (DASH) questionnaire and the Short-Form 12 (SF-12) were used. The SF-12 consists of a physical and mental component (PCS-SF-12 and MCS-SF-12). The questionnaires were completed during the preoperative and postoperative consultations and at 3, 6, and 12 months. RESULTS We performed 53 interventions. The population was mostly female (n = 35, 66.0%) of 40.1±10.0 years. The preoperative DASH score was 46.3±19.7. It was 40.9±21.7 at 6 weeks, 33.5±22.7 at 3 months, 28.9±22.6 at 6 months, and 21.1±20 at 9 to 12 months. The improvement of DASH becomes statistically significant at 3 months (p = 0.036), 6 months (p = 0.002), and 12 months (p = 0.001). The preoperative MCS-SF-12 was 36.6±9.4. It was 41.6±10.9 at 6 weeks, 43.8±11.1 at 3 months, 46.2±11.8 at 6 months, and 51.4±8 at 8 to 12 months. The improvement of MCS-SF-12 became significant at 3 months (p=0.009), 6 months (p=0.001), and 12 months (p=0.001). The preoperative PCS-SF-12 was 35.5±6.4. It was 37.1±8.7 at 6 weeks, 39.9±8.7 at 3 months, 41.6±8.4 at 6 months, and 46.1±8.1 to 12 months. The improvement of PCS-SF-12 became significant at 6 months (p=0.005) and 12 months (p=0.001). CONCLUSION The surgical management of TOS allows an improvement of quality of life in short and medium term.
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Affiliation(s)
- Myriam Ammi
- Department of Vascular and Thoracic Surgery, University Hospital, 49933 Angers, France.
| | - Jeanne Hersant
- Department of Vascular and Sport Investigations, University Hospital, 49933 Angers, France
| | - Samir Henni
- Department of Vascular and Thoracic Surgery, University Hospital, 49933 Angers, France
| | - Mickael Daligault
- Department of Vascular and Thoracic Surgery, University Hospital, 49933 Angers, France
| | - Xavier Papon
- Department of Vascular and Thoracic Surgery, University Hospital, 49933 Angers, France
| | - Pierre Abraham
- Department of Vascular and Sport Investigations, University Hospital, 49933 Angers, France
| | - Jean Picquet
- Department of Vascular and Thoracic Surgery, University Hospital, 49933 Angers, France
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Fouquet O, Dang Van S, Ammi M, Daligault M, Baufreton C, Picquet J. STABILISE Technique via a Transapical Approach to Repair Residual Type A Aortic Dissection. Aorta (Stamford) 2021; 9:161-164. [PMID: 34560805 PMCID: PMC8642071 DOI: 10.1055/s-0041-1729851] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
The stent-assisted balloon-induced intimal disruption and relamination in aortic dissection or STABILISE concept is a novel endovascular strategy in Type A and Type B dissections. We report a case of Type A aortic dissection repair combining, first, an open thoracic aortic surgery with an elephant trunk procedure and, second, an endovascular treatment using the STABILISE technique via a combined transapical approach commonly used for transcatheter aortic valve implantation and a femoral pathway.
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Affiliation(s)
- Olivier Fouquet
- Department of Cardiovascular and Thoracic Surgery, University Hospital, Angers, France.,MITOVASC Institute CNRS UMR 6214, INSERM U1083, University, Angers, France
| | - Simon Dang Van
- Department of Cardiovascular and Thoracic Surgery, University Hospital, Angers, France.,MITOVASC Institute CNRS UMR 6214, INSERM U1083, University, Angers, France
| | - Myriam Ammi
- Department of Cardiovascular and Thoracic Surgery, University Hospital, Angers, France
| | - Mickael Daligault
- Department of Cardiovascular and Thoracic Surgery, University Hospital, Angers, France
| | - Christophe Baufreton
- Department of Cardiovascular and Thoracic Surgery, University Hospital, Angers, France.,MITOVASC Institute CNRS UMR 6214, INSERM U1083, University, Angers, France
| | - Jean Picquet
- Department of Cardiovascular and Thoracic Surgery, University Hospital, Angers, France.,MITOVASC Institute CNRS UMR 6214, INSERM U1083, University, Angers, France
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Gouëffic Y, Picquet J, Schneider F, Kaladji A, Marret O, Muller L, Guyomarc'h B, Riche VP, Chaillou P, Guillou M, Nasr B. A Randomized Trial Comparing Polymer Versus Suture-Based Vascular Closure Devices for Arterial Closure Following Lower-Limb Arterial Endovascular Revascularization. Cardiovasc Intervent Radiol 2021; 44:1883-1892. [PMID: 34386892 DOI: 10.1007/s00270-021-02940-z] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/15/2021] [Accepted: 07/31/2021] [Indexed: 12/19/2022]
Abstract
PURPOSES The primary objective of this study (STEP trial) was to compare the efficacy of the polymer-based FemoSeal® vascular closure device (VCD) and the suture-based ProGlide® VCD in achieving hemostasis at the femoral access site after lower-limb arterial endovascular revascularization. MATERIALS AND METHODS STEP was a multicenter randomized clinical trial including patients undergoing lower-limb arterial endovascular revascularization. The primary endpoint was technical success 5 h after the VCD intervention, defined as achievement of hemostasis without the need for a follow-up intervention at the access site and without a 2-g/dL drop in hemoglobin. RESULTS Between December 2017 and April 2019, 113 patients were assigned to the FemoSeal® group (FS) and 117 to the ProGlide® group (PG). VCD interventions were technically successful for 90 FS patients (80%) and 58 PG patients (50%) (odds ratio, 3.98; 95% CI, 2.22 to 7.14; p < 0.0001). This difference in success rates between FS and PG is partly explained by more frequent recourse to manual compression (FS: n = 19; PG: n = 45) and an additional VCD (FS: n = 0; PG: n = 23) in the latter group. After 5 h, 87% of FS patients and 69% of PG patients resumed ambulation (odds ratio: 3.07; 95% CI: 1.93 to 6.15; p = 0.0016). CONCLUSIONS In patients undergoing lower-limb arterial endovascular revascularization, FemoSeal® was superior to ProGlide® in terms of technical success. CLINICAL TRIAL REGISTRATION Step trial was registered on http://ClinicalTrials.gov (NCT03192033).
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Affiliation(s)
- Yann Gouëffic
- Department of Vascular and Endovascular Surgery, Paris Saint Joseph Hospital, Paris, France.,Laboratoire de Physiopathologie de La Résorption Osseuse, INSERM-UN UMR 957, Nantes, France
| | - Jean Picquet
- Department of Vascular Surgery, Angers University Hospital, Angers, France
| | - Fabrice Schneider
- Department of Vascular Surgery, Poitiers University Hospital, Poitiers, France
| | - Adrien Kaladji
- Department of Cardiovascular and Thoracic Surgery, Rennes University Hospital, Rennes, France
| | - Olivier Marret
- Department of Vascular Surgery, La Roche-sur-Yon Hospital, La Roche-sur-Yon, France
| | - Laurent Muller
- Department of Vascular Surgery, Cholet Hospital, Cholet, France
| | - Béatrice Guyomarc'h
- Institut du Thorax, Nantes University Hospital/INSERM/CNRS/Nantes University, Nantes, France
| | - Valéry-Pierre Riche
- Division of Health Product Development and Economic Evaluation, Department of Partnerships and Innovation, Nantes University Hospital, Nantes, France
| | - Philippe Chaillou
- Department of Vascular Surgery, Institut du Thorax, Nantes University Hospital, Nantes, France
| | - Marie Guillou
- Department of Vascular Surgery, Institut du Thorax, Nantes University Hospital, Nantes, France
| | - Bahaa Nasr
- Department of Vascular Surgery, Brest University Hospital, Brest, France. .,Service de Chirurgie Vasculaire, CHU Brest, 29200, Brest, France.
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Hersant J, Ramondou P, Chavignier V, Chavanon A, Feuilloy M, Picquet J, Henni S, Abraham P. Forearm Volume Changes Estimated by Photo-Plethysmography During an Original Candlestick/Prayer Maneuver in Patients With Suspected Thoracic Outlet Syndrome. Front Physiol 2021; 12:652456. [PMID: 33927642 PMCID: PMC8076800 DOI: 10.3389/fphys.2021.652456] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2021] [Accepted: 03/08/2021] [Indexed: 11/28/2022] Open
Abstract
Objective: Hemodynamic investigations in thoracic outlet syndrome (TOS) remain difficult, even in trained hands. Results are generally reported as either presence or absence of venous compression. In fact, in patients with suspected TOS but without chronic venous occlusion, the forearm volume changes may result from various combinations of forearm position from heart level, arterial inflow, and/or venous outflow positional impairment. Design: Cross sectional, retrospective, single center study, accessible on Clinicaltrial.gov under reference NCT04376177. Material: We used venous photo-plethysmography (V-PPG) in 151 patients with suspected TOS. The subjects elevated their arms to the “candlestick” (Ca) position for 30 s and then kept their arm elevated in front of the body for an additional 15 s (“prayer” position; Pra). This CA–Pra procedure was repeated three times by each patient with recording of both arms. Method: We classified V-PPG recordings using an automatic clustering method. Result: The blinded clustering classification of 893 V-PPG recordings (13 missing files) resulted in four out of seven clusters, allowing the classification of more than 99% of the available recordings. Each cluster included 65.73, 6.16, 17.13, and 10.8% of the recordings, respectively. Conclusion: Venous hemodynamic profiles in TOS are not only either normal or abnormal. With V-PPG, four clusters were observed to be consistent with, and assumed to result from, the four possible associations of presence/absence of arterial inflow/venous outflow positional impairment: (1) normal response (maximal emptying in Ca and Pra), (2) isolated inflow impairment (emptying in Ca and filling in Pra due to post-ischemic vasodilation), (3) isolated venous outflow impairment (emptying then filling in Ca due to arterial inflow and emptying in Pra), and (4) simultaneous inflow/outflow impairment (emptying in Ca but no filling due to concomitant inflow impairment and further emptying in Pra).
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Affiliation(s)
- Jeanne Hersant
- Vascular Medicine, University Hospital, Angers, France.,UMR CNRS 1083 INSERM 6214, LUNAM University, Angers, France
| | - Pierre Ramondou
- Vascular Medicine, University Hospital, Angers, France.,UMR CNRS 1083 INSERM 6214, LUNAM University, Angers, France
| | | | | | - Mathieu Feuilloy
- School of Electronics (ESEO), Angers, France.,UMR CNRS 6613 LAUM, Le Mans, France
| | - Jean Picquet
- UMR CNRS 1083 INSERM 6214, LUNAM University, Angers, France.,Service of Thoracic and Vascular Surgery, University Hospital, Angers, France
| | - Samir Henni
- Vascular Medicine, University Hospital, Angers, France.,UMR CNRS 1083 INSERM 6214, LUNAM University, Angers, France
| | - Pierre Abraham
- Vascular Medicine, University Hospital, Angers, France.,UMR CNRS 1083 INSERM 6214, LUNAM University, Angers, France.,Sports and Exercise Medicine, University Hospital, Angers, France
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15
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Mahé G, Boge G, Bura-Rivière A, Chakfé N, Constans J, Goueffic Y, Lacroix P, Le Hello C, Pernod G, Perez-Martin A, Picquet J, Sprynger M, Behar T, Bérard X, Breteau C, Brisot D, Chleir F, Choquenet C, Coscas R, Detriché G, Elias M, Ezzaki K, Fiori S, Gaertner S, Gaillard C, Gaudout C, Gauthier CE, Georg Y, Hertault A, Jean-Baptiste E, Joly M, Kaladji A, Laffont J, Laneelle D, Laroche JP, Lejay A, Long A, Loric T, Madika AL, Magnou B, Maillard JP, Malloizel J, Miserey G, Moukarzel A, Mounier-Vehier C, Nasr B, Nelzy ML, Nicolini P, Phelipot JY, Sabatier J, Schaumann G, Soudet S, Tissot A, Tribout L, Wautrecht JC, Zarca C, Zuber A. Disparities Between International Guidelines (AHA/ESC/ESVS/ESVM/SVS) Concerning Lower Extremity Arterial Disease: Consensus of the French Society of Vascular Medicine (SFMV) and the French Society for Vascular and Endovascular Surgery (SCVE). Ann Vasc Surg 2021; 72:1-56. [DOI: 10.1016/j.avsg.2020.11.011] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2020] [Accepted: 11/05/2020] [Indexed: 12/24/2022]
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16
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Hersant J, Ramondou P, Picquet J, Feuilloy M, Abraham P, Henni S. Calf and non-calf hemodynamic recovery in patients with arterial claudication: Implication for exercise training. Microvasc Res 2021; 135:104143. [PMID: 33515566 DOI: 10.1016/j.mvr.2021.104143] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2021] [Accepted: 01/25/2021] [Indexed: 10/22/2022]
Abstract
BACKGROUND Previous studies in patients with arterial claudication have focused on calf hemodynamic recovery. We hypothesized that the duration of hemodynamic recovery with TcpO2 at calf and non-calf levels would be shorter than 10 min. We analyzed the factors that influence the recovery time. METHODS We monitored limb changes minus chest changes from rest (DROP) of transcutaneous oximetry on buttocks, thighs and calves, during and following a treadmill test (3.2 km/h; 10% grade). We calculated the time required to reach 50% (50%RT) and 10% (90%RT) of minimal DROP value (DROPm) from walking cessation. Regression analyses were used to determine the factors associated to 50%RT and 90%RT. RESULTS Of the 132 patients studied, 18.2% reported isolated non-calf pain by history. Of the 792 recovery time values, only 3 (0.4%) and 23 (2.9%) were in excess of 10 min for 50%RT and for 90%RT, respectively. A weak correlation was found between each of the 792 DROPm and 50%RT (r = -0.270, p < 0.001) as well as for 90%RT (r = -0.311 p < 0.001). Lowest DROPm and BMI (but not age, sex, the use of beta-blockers, the duration of the walking period) were associated to both 50%RT and 90%RT. CONCLUSION Although recovery duration correlates significantly with the severity of ischemia of the same location, a wide discrepancy exists and the longest recovery time does not always correlate to the localization of the most severe ischemia. Non-calf ischemia should be measured when one aims at objectifying the biological effects of exercise or the effects of treatments on recovery from exercise.
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Affiliation(s)
| | | | - Jean Picquet
- MitoVasc Institute UMR CNRS 6015/INSERM 1083, Faculty of Medicine, Angers University, France; Thoracic and Vascular Surgery, University Hospital, Angers, France
| | | | - Pierre Abraham
- MitoVasc Institute UMR CNRS 6015/INSERM 1083, Faculty of Medicine, Angers University, France; Sports Medicine, University Hospital Center, Angers, France.
| | - Samir Henni
- Vascular Medicine, University Hospital, Angers, France; MitoVasc Institute UMR CNRS 6015/INSERM 1083, Faculty of Medicine, Angers University, France
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Guillou M, Picquet J, Schneider F, Kaladji A, Marret O, Bague N, Guyomarc'h B, Chaillou P, Nasr B, Gouëffic Y. Femoseal® versus Proglide® for the closure of retrograde femoral accesses: a randomized study. Ann Vasc Surg 2020. [DOI: 10.1016/j.avsg.2020.08.023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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18
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Daligault M, Haupert G, Ammi M, Thouveny F, Enon B, Papon X, Picquet J. Transposition of the superior mesenteric artery with a venous patch of the left renal vein to treat the nutcracker syndrome - experience of 11 cases in Angers. Ann Vasc Surg 2020. [DOI: 10.1016/j.avsg.2020.08.078] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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19
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Abraham P, Hersant J, Ramondou P, Thouveny F, Feuilloy M, Picquet J, Henni S. Comparison of transcutaneous oximetry with symptoms and arteriography in thoracic outlet syndrome. Clin Hemorheol Microcirc 2020; 75:107-119. [PMID: 31929152 DOI: 10.3233/ch-190751] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND Non-invasive tests are still required to improve the holistic diagnostic approach of thoracic outlet syndrome (TOS). OBJECTIVES We aimed to analyze the diagnostic accuracy of the decrease from rest oxygen pressure (DROP) index of transcutaneous oximetry (TcpO2) in TOS. METHODS Seventy-six patients and 40 asymptomatic volunteers (Controls) were enrolled. In TOS-suspected patients, the arteriograms were investigated for the presence of≥75% stenosis. The area under receiver operating characteristics curve (AUC) analysis tested the ability of forearm TcpO2 during provocative maneuvers to discriminate patients from controls and, to predict a positive arteriographic findings in the 44 TOS-suspected patients that had an arteriography. RESULTS The media [25/75° centile] DROP values of controls and patients were -14 [-8/-22] mmHg and -22 [-12/-42] mmHg, respectively (p for Mann-Whitney<0.02). AUC analysis showed a significant ability of TcpO2 to predict the presence of subclavian arterial compression on arteriography (AUC, 0.694). CONCLUSIONS Although time consuming, tcpO2 is independent of the observer expertise and could be useful in TOS-suspected patients to select the patients that should undergo arteriography.
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Affiliation(s)
- Pierre Abraham
- Exercise investigation and Sports Medicine, University Hospital, Angers, France.,UMR CNRS 6015, INSERM 1228, Medical School, University of Angers, France
| | | | | | | | | | - Jean Picquet
- UMR CNRS 6015, INSERM 1228, Medical School, University of Angers, France.,Thoracic and Vascular Surgery, University Hospital, Angers, France
| | - Samir Henni
- UMR CNRS 6015, INSERM 1228, Medical School, University of Angers, France.,Vascular Radiology, University Hospital, Angers, France
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20
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Tesson P, Haupert G, Ammi M, Daligault M, Papon X, Enon B, Picquet J. Surgery of Renal Artery Aneurysms: A Monocentric Retrospective Study. Ann Vasc Surg 2020; 64:17-26. [DOI: 10.1016/j.avsg.2019.10.102] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2019] [Revised: 10/15/2019] [Accepted: 10/23/2019] [Indexed: 12/19/2022]
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21
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Henni S, Ramondou P, Duval G, Picquet J, Leftheriotis G, Abraham P. The risk of lower-limb superficial vein thrombosis relative to lower-limb venous thrombotic events is not increased in winter months. Phlebology 2020; 35:533-537. [PMID: 31924137 DOI: 10.1177/0268355519896729] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
OBJECTIVES Ambient temperature (that impacts differently venous flow in superficial and deep veins) could have a different effect on the risk of superficial and deep venous thrombosis. We searched for a trimestral variation of the risk of superficial venous thrombosis among all lower-limb thrombotic events (lower-limb thrombotic events = superficial venous thrombosis + deep venous thrombosis). METHODS We retrospectively analyzed the results of venous ultrasound investigations performed among 11,739 patients (aged 67 ± 19 years old, 56.1% males) referred for suspected lower-limb thrombotic events over a 12-year period. Chi-square test was used to compare the superficial venous thrombosis/lower-limb thrombotic events ratio observed by trimesters to a homogeneous distribution. RESULTS The proportion of lower-limb thrombotic events were 30.7%, 28.8%, 31.1%, and 31.4% (Chi2: 0.133; p = 0.987) of total investigations, while that of superficial venous thrombosis among all lower-limb venous thrombotic events were 27.2%, 30.0%, 31.4%, and 31.0%, for the first, second, third, and fourth trimesters respectively (Chi2: 0.357; p: 0.949). CONCLUSION No trimestral variation of the superficial venous thrombosis/lower-limb venous thrombotic events ratio was observed.
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Affiliation(s)
- Samir Henni
- Department of Vascular Medicine, Mitovasc Institute, Angers, France.,UMR INSERM 1083/CNRS 6015, Université Bretagne Loire, Rennes, France
| | - Pierre Ramondou
- Department of Vascular Medicine, Mitovasc Institute, Angers, France
| | - Guillaume Duval
- Department of Gerontology, University Hospital, Angers, France
| | - Jean Picquet
- UMR INSERM 1083/CNRS 6015, Université Bretagne Loire, Rennes, France.,Department of Vascular and Thoracic Surgery, Mitovasc Institute, Angers, France
| | | | - Pierre Abraham
- Department of Vascular Medicine, Mitovasc Institute, Angers, France.,UMR INSERM 1083/CNRS 6015, Université Bretagne Loire, Rennes, France
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22
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Haupert G, Ammi M, Hersant J, Daligault M, Tesson P, Papon X, Picquet J. Treatment of Carotid Restenoses after Endarterectomy: A Retrospective Monocentric Study. Ann Vasc Surg 2020; 64:43-53. [PMID: 31923595 DOI: 10.1016/j.avsg.2019.10.103] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2019] [Revised: 10/13/2019] [Accepted: 10/16/2019] [Indexed: 10/25/2022]
Abstract
BACKGROUND To compare the different techniques for the treatment of carotid restenosis after carotid artery endarterectomy (CAE). METHODS Among 1,218 carotid surgeries carried out in our center between January 2010 and November 2017, 45 procedures were performed for carotid restenosis after CAE, including 11 by iterative conventional surgery and 34 with endovascular techniques (7 transluminal angioplasties alone [TLA], 9 carotid artery stenting [CAS], and 18 angioplasties with active balloons [drug-coated balloon {DCB}]). Perioperative data (cumulated rate of morbimortality [CRMM], duration of hospitalization) and postoperative results (survival, symptomatic restenoses > 50% or asymptomatic stenoses > 70% on ultrasound, reinterventions) were collected retrospectively and analyzed with Fisher's exact test. The long-term results were estimated according to the Kaplan-Meier estimator and were compared with the log rank test (P < 0.05 was regarded as significant). RESULTS There was one secondary death due to a massive postoperative stroke in the endovascular (ENDO) group. No significant difference regarding CRMM (2.9%, P = 0.756) between the iterative conventional surgery (open surgery; OS) and the ENDO groups of was observed. Three hematomas were found in the OS group versus one in the ENDO group (P = 0.04). The length of hospital stay was shorter in the ENDO group (P < 0.001). No difference was found between the ENDO group and the OS group regarding the two-year survival or the survival without recurrent restenosis (86 vs. 100%, log rank = 0.804, and log rank = 0.114). There were 5 restenoses >70% and two reinterventions in the ENDO group (P > 0.05). The comparison of the different endovascular techniques did not show significant differences regarding the CRMM, the one-year overall survival, the survival without recurrent restenosis, or the survival without reintervention (89% in the DCB and CAS groups vs. 100% in the percutaneous transluminal angioplasty [PTA] group, log rank = 0.286; 87% in the DCB group vs. 100% in the PTA and CAS groups, log rank = 0.137; and 94% in the DCB group vs. 100% in the PTA and CAS groups, log rank = 0.585, respectively). CONCLUSIONS In our experience, endovascular procedures are equivalent to iterative conventional surgery for the treatment of carotid restenoses in terms of major complications, news restenoses, or survival with less hematoma and a shorter duration of hospitalization. We however could not identify the best endovascular strategy in this indication, and a controlled study comparing the various endovascular strategies is proposed.
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Affiliation(s)
- Gautier Haupert
- Service de chirurgie vasculaire, Centre Hospitalier Universitaire d'Angers, Angers, France.
| | - Myriam Ammi
- Service de chirurgie vasculaire, Centre Hospitalier Universitaire d'Angers, Angers, France
| | - Jeanne Hersant
- Service de chirurgie vasculaire, Centre Hospitalier Universitaire d'Angers, Angers, France
| | - Mickael Daligault
- Service de chirurgie vasculaire, Centre Hospitalier Universitaire d'Angers, Angers, France
| | - Pierre Tesson
- Service de chirurgie vasculaire, Centre Hospitalier Universitaire d'Angers, Angers, France
| | - Xavier Papon
- Service de chirurgie vasculaire, Centre Hospitalier Universitaire d'Angers, Angers, France
| | - Jean Picquet
- Service de chirurgie vasculaire, Centre Hospitalier Universitaire d'Angers, Angers, France
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Abraham P, Hersant J, Ramondou P, Picquet J, Feuilloy M, Henni S. Comparison of exercise oximetry and ankle pressure measurements for patients with intermittent claudication: an observational study of 433 patients. Pflugers Arch 2020; 472:293-301. [DOI: 10.1007/s00424-019-02340-w] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2019] [Revised: 11/21/2019] [Accepted: 12/06/2019] [Indexed: 10/25/2022]
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24
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Hersant J, Ramondou P, Guilleron C, Picquet J, Henni S, Abraham P. A pilot study of forearm microvascular impairment and pain while using a telephone. Microvasc Res 2019; 129:103963. [PMID: 31790665 DOI: 10.1016/j.mvr.2019.103963] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2019] [Revised: 11/25/2019] [Accepted: 11/26/2019] [Indexed: 12/23/2022]
Abstract
OBJECTIVE To determine if using a telephone can induce forearm pain and ischemia. DESIGN Prospective case-control trial. SETTING Vascular laboratory in the university hospital in Angers between September 2018 and March 2019. PARTICIPANTS Fifteen apparently healthy subjects (controls) and 32 patients with suspected thoracic outlet syndrome (TOS) of vascular or non-vascular origin. INTERVENTION Hand-holding a cellular phone to answer a call from investigators. MAIN OUTCOME MEASURES Presence of forearm fatigue or pain (primary outcome), ability to hold the phone with each hand for 1 min (secondary outcome 1) and decrease in forearm transcutaneous oxygen pressure DROP index indicating forearm ischemia (secondary outcome 2). A DROP < -15 mm Hg defined ischemia. RESULTS Answering a phone call resulted in 25(78%) patients with forearm fatigue or pain and in 18 (56%) cases in the inability to hold the phone for 1 min, on one or both arms in patients with suspected TOS, but never occurred in healthy volunteers (p < .05 and p < .001). The presence of ischemia was observed in one or both arms in 10 (31%) patients with proved TOS and was always associated to phone-induced pain. Three (20%) of the controls had phone-induced ischemia. All had asymptomatic TOS and remained asymptomatic during the phone test (p = .42 from suspected-TOS patients). CONCLUSION The phone conversation resulted in pain in many patients with suspected TOS. Transcutaneous oximetry can document the underlying ischemia. Forearm phone-call-induced pain may be indicative of TOS provided that no earplug or headset is used. Trial registrationClinicalTrials.govNCT03355274.
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Affiliation(s)
- Jeanne Hersant
- Vascular Medicine, University Hospital Center, Angers, France
| | - Pierre Ramondou
- Vascular Medicine, University Hospital Center, Angers, France; Sports Medicine, University Hospital Center, Angers, France
| | - Celine Guilleron
- Sports Medicine, University Hospital Center, Angers, France; Laboratory Movement Interactions performance; MIP EA4334, F-72000 Le Mans, France
| | - Jean Picquet
- Vascular and thoracic surgery, University Hospital Center, Angers, France; UMR INSERM 1083-CNRS 6015, Mitovasc Institute, Angers, France
| | - Samir Henni
- Vascular Medicine, University Hospital Center, Angers, France; UMR INSERM 1083-CNRS 6015, Mitovasc Institute, Angers, France
| | - Pierre Abraham
- Vascular Medicine, University Hospital Center, Angers, France; Sports Medicine, University Hospital Center, Angers, France; UMR INSERM 1083-CNRS 6015, Mitovasc Institute, Angers, France.
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25
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Tesson P, Haupert G, Ammi M, Daligault M, Papon X, Enon B, Picquet J. Surgery of the aneurisms of the renal arteries: monocentric retrospective study. Ann Vasc Surg 2019. [DOI: 10.1016/j.avsg.2019.08.025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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26
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Henni S, Ammi M, Semporé Y, Hersant J, Zegar G, Gourdier AS, Picquet J, Abraham P. Treadmill Measured vs. Questionnaire Estimated Changes in Walking Ability in Patients With Peripheral Artery Disease. Eur J Vasc Endovasc Surg 2019; 57:676-684. [PMID: 30982731 DOI: 10.1016/j.ejvs.2018.11.015] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2018] [Accepted: 11/22/2018] [Indexed: 11/26/2022]
Abstract
OBJECTIVE Determining the maximum walking time (MWT) using the treadmill test is the gold standard method for evaluating walking capacity and treatment effect in patients with peripheral arterial disease (PAD). However, self reported functional disability is important when assessing quality of life. Changes in the Walking Estimated Limitation Calculated by History (WELCH) questionnaire scores were compared with the MWT. METHODS A cross sectional study was performed in patients with intermittent claudication. The treadmill test (3.2 km/h; 10% gradient) and WELCH questionnaire were administered to all patients for objective evaluation of walking capacity. Given the log normal distribution of these parameters in patients with PAD, a log transformation was applied to the WELCH score (LnW) and maximum walking time (LnT). The responsiveness of the WELCH score was determined using mean changes and correlation coefficients of LnW and LnT changes. The effect of time on the "estimated minus real" (E - R) changes (LnW - change minus LnT - change) was assessed after categorisation of patients into various test-retest intervals. Patients who underwent lower limb revascularisation between the two tests and those who underwent medical treatment only were analysed. RESULTS Correlation coefficients between LnW and LnT for tests 1 and 2 were r = 0.514 and r = 0.503, respectively (p < .001, for both). Correlation for LnW change vs. LnT change was 0.384 (p < .001). E - R was positive only early after surgery. E - R was negative for all test-retest intervals >1 year in revascularised and non-revascularised patients. CONCLUSION Changes in WELCH scores correlated with changes observed on the treadmill in patients with intermittent claudication. For long test-retest intervals, WELCH changes tended to overestimate the worsening of walking impairment as compared with the measured difference observed in both revascularised and non-revascularised patients. A shortlived "honeymoon" (overestimation of the benefit for the shortest test-retest interval) was observed only in revascularised patients.
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Affiliation(s)
- Samir Henni
- Vascular Medicine Department, University Hospital Centre of Angers, Angers, France
| | - Myriam Ammi
- Vascular Surgery Department, University Hospital Centre of Angers, Angers, France
| | - Yves Semporé
- Laboratoire de Physiologie, Institut Supérieur des Sciences de la Santé, Université Nazi Boni, Bobo-Dioulasso, Burkina Faso
| | - Jeanne Hersant
- Vascular Medicine Department, University Hospital Centre of Angers, Angers, France
| | - Geoffrey Zegar
- Vascular Medicine Department, University Hospital Centre of Angers, Angers, France
| | - Anne-Sophie Gourdier
- Vascular Medicine Department, University Hospital Centre of Angers, Angers, France
| | - Jean Picquet
- Vascular Surgery Department, University Hospital Centre of Angers, Angers, France; UMR CNRS 6015, INSERM U1083, Mitovasc Institute, Angers, France
| | - Pierre Abraham
- Vascular Surgery Department, University Hospital Centre of Angers, Angers, France; UMR CNRS 6015, INSERM U1083, Mitovasc Institute, Angers, France.
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Ammi M, Henni S, Salomon Du Mont L, Settembre N, Loubiere H, Sobocinski J, Gouëffic Y, Feugier P, Duprey A, Martinez R, Bartoli M, Coscas R, Chaufour X, Kaladji A, Rosset E, Abraham P, Picquet J. Lower Rate of Restenosis and Reinterventions With Covered vs Bare Metal Stents Following Innominate Artery Stenting. J Endovasc Ther 2019; 26:385-390. [DOI: 10.1177/1526602819838867] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
Purpose: To determine any difference between bare metal stents (BMS) and balloon-expandable covered stents in the treatment of innominate artery atheromatous lesions. Materials and Methods: A multicenter retrospective study involving 13 university hospitals in France collected 93 patients (mean age 63.2±11.1 years; 57 men) treated over a 10-year period. All patients had systolic blood pressure asymmetry >15 mm Hg and were either asymptomatic (39, 42%) or had carotid (20, 22%), vertebrobasilar (24, 26%), and/or brachial (20, 22%) symptoms. Innominate artery stenosis ranged from 50% to 70% in 4 (4%) symptomatic cases and between 70% and 90% in 52 (56%) cases; 28 (30%) lesions were preocclusive and 8 (9%) were occluded. One (1%) severely symptomatic patient had a <50% stenosis. Demographic characteristics, operative indications, and procedure details were compared between the covered (36, 39%) and BMS (57, 61%) groups. Multivariate analysis was performed to determine relative risks of restenosis and reinterventions [reported with 95% confidence intervals (CI)]. Results: The endovascular procedures were performed mainly via retrograde carotid access (75, 81%). Perioperative strokes occurred in 4 (4.3%) patients. During the mean 34.5±31.2–month follow-up, 30 (32%) restenoses were detected and 13 (20%) reinterventions were performed. Relative risks were 6.9 (95% CI 2.2 to 22.2, p=0.001) for restenosis and 14.6 (95% CI 1.8 to 120.8, p=0.004) for reinterventions between BMS and covered stents. The severity of the treated lesions had no influence on the results. Conclusion: Patients treated with BMS for innominate artery stenosis have more frequent restenoses and reinterventions than patients treated with covered stents.
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Affiliation(s)
- Myriam Ammi
- Service de Chirurgie Vasculaire, CHU Angers, France
| | - Samir Henni
- Service de Médecine Vasculaire, CHU Angers, France
| | | | | | | | | | | | | | | | | | - Michel Bartoli
- Service de Chirurgie Vasculaire, Assistance Publique–Hôpitaux de Marseille, France
| | - Raphael Coscas
- Service de Chirurgie Vasculaire, Hôpital Ambroise Paré, Paris, France
| | | | | | - Eugenio Rosset
- Service de Chirurgie Vasculaire, CHU Clermont Ferrand, France
| | | | - Jean Picquet
- Service de Chirurgie Vasculaire, CHU Angers, France
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Henni S, Bauer P, Le Meliner T, Hersant J, Papon X, Daligault M, Chretien JM, Ammi M, Picquet J, Abraham P. High prevalence of exercise-induced ischemia in the asymptomatic limb of patients with apparently strictly unilateral symptoms and unilateral peripheral artery disease. Ther Adv Cardiovasc Dis 2019; 13:1753944718819063. [PMID: 30803404 PMCID: PMC6348574 DOI: 10.1177/1753944718819063] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/28/2022] Open
Abstract
BACKGROUND: The prevalence of exercise-induced ischemia in the asymptomatic limb of patients with unilateral claudication based on history and treadmill evaluation, and with unilateral ipsilateral peripheral artery disease (i.e ankle-to-brachial systolic pressure index <0.90) is unknown. METHODS: We detected exercise-induced ischemia in the asymptomatic limb of patients with apparently unilateral claudication. Among 6059 exercise-oximetry tests performed in 3407 nondiabetic and 961 diabetic patients. We estimated the intensity of ischemia in the both limb (buttocks and calves) using the lowest minimum value of the decrease from rest of oxygen pressure (DROP; limb changes minus chest changes from rest), with significant ischemia defined as DROP lower than -15 mmHg. RESULTS: We found 152 tests performed in 142 nondiabetic patients and 40 tests performed in 38 diabetic patients. The asymptomatic limb showed significant ischemia in 46.7% and 37.5% of the tests. Strictly unilateral exercise-induced claudication with apparently unilateral peripheral artery disease was rare (<4% of all tests). However, among these highly selected tests, significant ischemia was found in the asymptomatic limb in more than one-third of cases. CONCLUSION: The asymptomatic limb of patients with peripheral artery disease should not be considered a normal limb.
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Affiliation(s)
- Samir Henni
- Department of Vascular Investigation, University of Angers Hospital, France.,UMR Mitovasc CNRS6015-INSERM 1083, University of Angers, France
| | - Pascal Bauer
- Cardiology and Angiology, University Hospital Giessen, Germany
| | - Tanguy Le Meliner
- Department of Vascular Investigation, University of Angers Hospital, France
| | - Jeanne Hersant
- Department of Vascular Investigation, University of Angers Hospital, France
| | - Xavier Papon
- Department of Vascular and thoracic Surgery, University of Angers Hospital, France
| | - Mickael Daligault
- Department of Vascular and thoracic Surgery, University of Angers Hospital, France
| | - Jean-Marie Chretien
- Department of Biostatistics and Data Management, University of Angers Hospital, France
| | - Myriam Ammi
- Department of Vascular and thoracic Surgery, University of Angers Hospital, France
| | - Jean Picquet
- Department of Vascular and thoracic Surgery, University of Angers Hospital, France.,UMR Mitovasc CNRS6015-INSERM 1083, University of Angers, France
| | - Pierre Abraham
- Laboratoire d'Explorations Vasculaires; Centre Hospitalier Universitaire, 49033 Angers Cedex 01, France
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Henni S, Hersant J, Ammi M, Mortaki FE, Picquet J, Feuilloy M, Abraham P. Microvascular Response to the Roos Test Has Excellent Feasibility and Good Reliability in Patients With Suspected Thoracic Outlet Syndrome. Front Physiol 2019; 10:136. [PMID: 30846945 PMCID: PMC6393400 DOI: 10.3389/fphys.2019.00136] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2018] [Accepted: 02/06/2019] [Indexed: 12/03/2022] Open
Abstract
Background: Exercise oximetry allows operator-independent recordings of microvascular blood flow impairments during exercise and can be used during upper arm provocative maneuvers. Objective: To study the test-retest reliability of upper-limb oximetry during the Roos test in patients with suspected thoracic outlet syndrome (TOS). Materials and Methods: Forty-two patients (28 men, 14 women; mean age: 40.8 years) were examined via transcutaneous oxygen pressure (TcpO2) recordings during two consecutive Roos tests in the standing position. The minimal decrease from rest of oxygen pressure (DROPmin) value was recorded after each maneuver was performed on both arms. The area under the receiver operating characteristic (ROC) curve defined the DROPmin diagnostic performance in the presence of symptoms during the tests. The Mann–Whitney U-test was used to compare the DROPmin in the symptomatic vs. asymptomatic arms. The test-retest reliability was analyzed with Bland-Altman representations. The results are presented as means ± standard deviations (SD) or medians [25–75 percentiles]. Results: The symptoms by history were different from the symptoms expressed during the Roos maneuvers in one-third of the patients. The DROPmin measurements were −19 [−36; −7] mmHg and −8 [−16; −5] mmHg in the symptomatic (n = 108) and asymptomatic (n = 60) arms, respectively. When TOS observed on ultrasound imaging was the endpoint, the area under the ROC curve (AUC) was 0.725 ± 0.058, with an optimal cutoff point of −15 mmHg. This value provided 67% sensitivity and 78% specificity for the presence TOS via ultrasound. When symptoms occurring during the test represented the endpoint, the AUC was 0.698 ± 0.04, with a cutoff point of −10 mmHg. This provided 62% sensitivity and 66% specificity for the presence of pain in the ipsilateral arm during the test. The test-retest reliability of DROPmin proved to be good but not perfect, partly because of unreliability of the provocation maneuvers. Conclusion: To the best of our knowledge, this study is the first to investigate microvascular responses during the Roos maneuver in patients with suspected TOS. The presence of symptoms was significantly associated with ischemia. TcpO2 facilitated the recording of both macrovascular and microvascular responses to the Roos test. The Roos maneuver should probably be performed at least twice in patients with suspected TOS.
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Affiliation(s)
- Samir Henni
- Vascular Medicine, University Hospital Center, Angers, France.,UMR INSERM 1083 - CNRS 6015, Mitovasc Institute, Angers, France
| | - Jeanne Hersant
- Vascular Medicine, University Hospital Center, Angers, France
| | - Myriam Ammi
- Department of Cardiovascular and Thoracic Surgery, University Hospital Center, Angers, France
| | | | - Jean Picquet
- UMR INSERM 1083 - CNRS 6015, Mitovasc Institute, Angers, France.,Department of Cardiovascular and Thoracic Surgery, University Hospital Center, Angers, France
| | | | - Pierre Abraham
- UMR INSERM 1083 - CNRS 6015, Mitovasc Institute, Angers, France.,Sports Medicine, University Hospital Center, Angers, France
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Henni S, Ammi M, Gourdier AS, Besnier L, Signolet I, Colas-Ribas C, Picquet J, Abraham P. Ankle brachial index is equally predictive of exercise-induced limb ischemia in diabetic and non-diabetic patients with walking limitation. J Diabetes Complications 2018; 32:702-707. [PMID: 29724591 DOI: 10.1016/j.jdiacomp.2018.03.011] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/24/2017] [Revised: 02/20/2018] [Accepted: 03/25/2018] [Indexed: 01/09/2023]
Abstract
BACKGROUND In diabetic patients, arterial stiffness may impair compressibility of vessels and result in higher ankle to brachial index (ABI) than in non-diabetic subjects. METHODS We studied 1972 non-diabetic and 601 diabetic patients, with suspected peripheral artery disease, Exercise transcutaneous oxygen pressure (Ex-tcpO2), expressed in DROP index (limb tcpO2 change minus chest tcpO2 change), is insensitive to arterial stiffness and can estimate exercise-induced regional blood flow impairment (RBFI). A minimal DROP <-15 mm Hg indicates the presence of RBFI (positive test). ABI was simplified to a category variable (ABIc) by rounding ABI to the closest first decimal. RESULTS In the ABIc range 0.4 to 1.1 linear regression for mean DROP values were: y = 34 x - 53; (R2 = 0.211) and y = 33 x - 52; (R2 = 0.186) in diabetic and Non-diabetic patients, respectively. Both Db and non-D patients showed a high proportion of positive Ex-tcpO2 tests for ABIc in the normal range (ABIc: 1.0 and over) from 27.1 to up to 58%. More than half of patients with borderline ABI (ABIc = 0.9) had RBFI during exercise. it was 65.6% in diabetic and 58.5% non-diabetic patients. CONCLUSIONS Resting ABI was not a better predictor of exercise-induced RBFI in non-Db than in Diabetic patients. Our results highlights the interest of still measuring resting-ABI in diabetic patients to argue for the vascular origin of exertional limb pain, but also of performing exercise tests in patients with walking impairment.
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Affiliation(s)
- Samir Henni
- Department of Physiology and Functional Investigations, University Hospital, 49933 Angers Cedex 09, France; Mitovasc Institute, UMR INSERM 1083/CNRS 6015, University of Angers, Université Bretagne Loire, France
| | - Myriam Ammi
- Vascular and Thoracic Surgery, University Hospital, 49933 Angers Cedex 09, France
| | - Anne-Sophie Gourdier
- Department of Physiology and Functional Investigations, University Hospital, 49933 Angers Cedex 09, France
| | - Louis Besnier
- Radiology Department, University Hospital, 49933 Angers Cedex 09, France
| | - Isabelle Signolet
- Department of Physiology and Functional Investigations, University Hospital, 49933 Angers Cedex 09, France
| | - Christophe Colas-Ribas
- Department of Physiology and Functional Investigations, University Hospital, 49933 Angers Cedex 09, France
| | - Jean Picquet
- Mitovasc Institute, UMR INSERM 1083/CNRS 6015, University of Angers, Université Bretagne Loire, France; Vascular and Thoracic Surgery, University Hospital, 49933 Angers Cedex 09, France
| | - Pierre Abraham
- Department of Physiology and Functional Investigations, University Hospital, 49933 Angers Cedex 09, France; Mitovasc Institute, UMR INSERM 1083/CNRS 6015, University of Angers, Université Bretagne Loire, France.
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Henni S, Mahe G, Lamotte C, Laurent R, Riviere AB, Aubourg M, Sarlon G, Laneelle D, Long A, Signolet I, Picquet J, Feuilloy M, Abraham P. Exercise transcutaneous oximetry significantly modifies the diagnostic hypotheses and impacts scheduled investigations or treatments of patients with exertional limb pain. Eur J Intern Med 2018; 52:28-34. [PMID: 29306678 DOI: 10.1016/j.ejim.2018.01.008] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/19/2017] [Revised: 12/05/2017] [Accepted: 01/02/2018] [Indexed: 10/18/2022]
Abstract
INTRODUCTION In lower extremity peripheral artery disease (PAD), transcutaneous oximetry at exercise (Ex-TcpO2) has been largely validated in research practice, but evidence of routine practice in various vascular laboratories is missing. We hypothesized that Ex-TcPO2 would change the diagnosis hypotheses, investigations and treatments for patients referred for exertional limb pain. MATERIAL & METHODS A multicenter prospective trial was conducted in nine different referral centers. Investigators performed Ex-TcpO2 and recorded investigations and treatments already scheduled for the patient. We encoded referral physician's diagnostic hypothesis. Before Ex-TcpO2, vascular physicians were asked to give their diagnosis hypotheses. A minimal decrease from rest of oxygen pressure (DROP)<minus 15mmHg defined the presence of exercise-induced ischemia on the area of interest. After Ex-TcPO2, we recorded post-test diagnostic hypothesis and investigations and treatments to be cancelled or performed. We compared the diagnosis hypotheses, scheduled investigations and treatments, before and after the Ex-TcpO2. RESULTS We included 603 patients (485 males: 80.4%), aged 64.7±9.8years. The post-test diagnosis hypothesis differed in 266 patients (44.1%; p<0.0001) and in 96 patients (15.9%) from the pre-test hypothesis of referring and vascular physician, respectively. This led to the recommendation to cancel 27 scheduled investigations or treatments of a total cost of ~130,000 euros. DISCUSSION Ex-TcPO2 in patients with exertional limb pain is applicable in various vascular institutions, and significantly modifies the diagnostic hypotheses and impacts scheduled investigations or treatments of patients with exertional limb pain.
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Affiliation(s)
- Samir Henni
- Explorations vasculaires adulte enfant, University Hospital, Angers, France
| | - Guillaume Mahe
- Unité de Médecine Vasculaire, INSERM CIC 1414, Université de Rennes 1, University Hospital, Rennes, France
| | - Christophe Lamotte
- Department of Internal Medicine, University Hospital, 59037 Lille Cedex, France
| | - Remi Laurent
- Département de pathologie vasculaire, Hôpital St Philibert, BP 249, 59462 Lomme Cedex, France
| | | | | | - Gabrielle Sarlon
- Unité de Médecine Vasculaire, Assistance Publique Hôpitaux de Marseille - Hôpital de la Timone, Marseille, France; Unité INSERM 1062, INRA 1260, Aix-Marseille Université, France
| | - Damien Laneelle
- Médecine Vasculaire, Centre Hospitalier Universitaire, 14033 Caen cedex 9, France
| | - Anne Long
- Médecine Vasculaire, Groupement Hospitalier Edouard Herriot, Hospices Civils de Lyon, University Hospital, Lyon, France; Univ. Lyon, INSA-Lyon, Université Claude Bernard Lyon 1, UJM-Saint Etienne, CNRS, Inserm, CREATIS UMR 5220, U1206, F-69003 Lyon, France
| | - Isabelle Signolet
- Explorations vasculaires adulte enfant, University Hospital, Angers, France
| | - Jean Picquet
- Department of Vascular and Cardiothoracic Surgery, University Hospital, Angers, France; Mitovasc Institute, UMR CNRS-6015, INSERM-1083, University of Angers, France
| | | | - Pierre Abraham
- Explorations vasculaires adulte enfant, University Hospital, Angers, France; Mitovasc Institute, UMR CNRS-6015, INSERM-1083, University of Angers, France.
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Signolet I, Abraham P, Chupin S, Ammi M, Gueguen N, Letournel F, Picquet J, Baufreton C, Daligault M, Procaccio V, Reynier P, Henni S. Mitochondrial complex I defect resulting from exercise-induced lower limb ischemia in patients with peripheral arterial disease. J Appl Physiol (1985) 2018; 125:938-946. [PMID: 29792553 DOI: 10.1152/japplphysiol.00059.2018] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
This study aims to compare the structural and mitochondrial alterations between muscle segments affected by exercise-induced ischemia and segments of the same muscle without ischemia, in the same subject. In a prospective analysis, 34 patients presenting either peripheral arterial disease or chronic coronary syndrome without any evidence of peripheral arterial disease were eligible for inclusion based on findings indicating a need for either a femoro-popliteal bypass or a saphenous harvesting for coronary bypass. Before surgery, we assessed the level of exercise-induced ischemia in proximal and distal sections of the thigh by the measurement of transcutaneous oxygen pressure during an exercise treadmill test. Distal and proximal biopsies of the sartorius muscle were procured during vascular surgical procedures to assess mitochondrial function and morphometric parameters of the sartorius myofibers. Comparisons were made between the distal and proximal biopsies, with respect to these parameters. Thirteen of the study patients that initially presented with peripheral arterial disease had evidence of an isolated distal thigh exercise-induced ischemia, associated with a 35% decrease in the mitochondrial complex I enzymatic activity in the distal muscle biopsy. This defect was also associated with a decreased expression of the manganese superoxide dismutase enzyme and with alterations of the shapes of the myofibers. No functional or structural alterations were observed in the patients with coronary syndrome. We validated a specific model ischemia in peripheral arterial disease characterized by muscular alterations. This "Distal-Proximal-Sartorius Model" would be promising to explore the physiopathological consequences specific to chronic ischemia. NEW & NOTEWORTHY We compared proximal versus distal biopsies of the sartorius muscle in patients with superficial femoral artery stenosis or occlusion and proof of, distal only, regional blood flow impairment with exercise oximetry. We identified a decrease in the mitochondrial complex I enzymatic activity and antioxidant system impairment at the distal level only. We validate a model to explore the physiopathological consequences of chronic muscle ischemia.
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Affiliation(s)
- I Signolet
- Laboratory for Vascular Investigation, University Hospital , Angers , France.,Department of Biochemistry and Genetics, University Hospital , Angers , France
| | - P Abraham
- Laboratory for Vascular Investigation, University Hospital , Angers , France.,Mitovasc Institute, CNRS 6015, INSERM U1083, University of Angers , Angers , France
| | - S Chupin
- Department of Biochemistry and Genetics, University Hospital , Angers , France.,Mitovasc Institute, CNRS 6015, INSERM U1083, University of Angers , Angers , France
| | - M Ammi
- Department of Vascular Surgery, University Hospital , Angers , France
| | - N Gueguen
- Department of Biochemistry and Genetics, University Hospital , Angers , France.,Mitovasc Institute, CNRS 6015, INSERM U1083, University of Angers , Angers , France
| | - F Letournel
- Department of Tissue and Cellular Pathology, University Hospital , Angers , France
| | - J Picquet
- Department of Vascular Surgery, University Hospital , Angers , France
| | - C Baufreton
- Department of Cardiac Surgery, University Hospital , Angers , France
| | - M Daligault
- Department of Vascular Surgery, University Hospital , Angers , France
| | - V Procaccio
- Department of Biochemistry and Genetics, University Hospital , Angers , France.,Mitovasc Institute, CNRS 6015, INSERM U1083, University of Angers , Angers , France
| | - P Reynier
- Department of Biochemistry and Genetics, University Hospital , Angers , France.,Mitovasc Institute, CNRS 6015, INSERM U1083, University of Angers , Angers , France
| | - S Henni
- Laboratory for Vascular Investigation, University Hospital , Angers , France.,Mitovasc Institute, CNRS 6015, INSERM U1083, University of Angers , Angers , France
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Abraham P, Colas-Ribas C, Signolet I, Ammi M, Feuilloy M, Picquet J, Henni S. Transcutaneous Exercise Oximetry for Patients With Claudication ― A Retrospective Review of Approximately 5,000 Consecutive Tests Over 15 Years ―. Circ J 2018; 82:1161-1167. [PMID: 29343673 DOI: 10.1253/circj.cj-17-0948] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Affiliation(s)
- Pierre Abraham
- Laboratory for Vascular Investigations, University Hospital
- Institut MITOVASC, UMR CNRS 6015, INSERM U1083, University of Angers
| | | | | | - Myriam Ammi
- Department of Vascular and Thoracic Surgery, University Hospital
| | | | - Jean Picquet
- Department of Vascular and Thoracic Surgery, University Hospital
- Institut MITOVASC, UMR CNRS 6015, INSERM U1083, University of Angers
| | - Samir Henni
- Laboratory for Vascular Investigations, University Hospital
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Tesson P, Ammi M, Lecluse A, Daligault M, Papon X, Picquet J. Place of carotid surgery in the management of CVAs. Ann Vasc Surg 2017. [DOI: 10.1016/j.avsg.2017.06.115] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Ammi M, Loubiere H, Sobocinski J, Goueffic Y, Feugier P, Dupre A, Martinez R, Bartoli M, Coscas R, Chaufour X, Cardon A, Rosset E, Picquet J. Which stent to use for angioplasties of the brachio-cephalic arterial trunk? Ann Vasc Surg 2017. [DOI: 10.1016/j.avsg.2017.06.118] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Ammi M, Dessertenne G, Henni S, Abraham P, Enon B, Papon X, Daligault M, Picquet J. Long-term results of the surgical treatment of external iliac endofibrosis. Ann Vasc Surg 2017. [DOI: 10.1016/j.avsg.2017.06.082] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Ammi M, Péret M, Henni S, Daligault M, Abraham P, Papon X, Enon B, Picquet J. Frequency of the Pectoralis Minor Compression Syndrome in Patients Treated for Thoracic Outlet Syndrome. Ann Vasc Surg 2017; 47:253-259. [PMID: 28943489 DOI: 10.1016/j.avsg.2017.09.002] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2016] [Revised: 05/04/2017] [Accepted: 09/01/2017] [Indexed: 11/19/2022]
Abstract
BACKGROUND Pectoralis minor compression syndrome (PMCS) is a compression of the neurovascular structures in the subpectoral tunnel and remains underestimated in the management of patients with thoracic outlet syndrome (TOS). Its underdiagnosis may be responsible for incomplete or failed treatment. The aim of the study was to evaluate the frequency of PMCS in our experience. METHODS We retrospectively reviewed all patients treated for TOS in our department. We selected those in whom PMCS was diagnosed with a systematic dynamic arteriography. Surgery was performed using the Roos axillary approach when a first rib resection was associated or an elective approach when a first rib resection was not associated. RESULTS From January 2004 to December 2014, 374 surgeries for TOS were performed in 279 patients, which included 90 men (sex ratio = 0.48) with a mean age of 40.1 ± 10 years old. Among these patients, 63 (22.5%) underwent 82 interventions (21.9%) for PMCS, including 26 men (sex ratio = 0.70, P < 0.05) with a mean age of 37.9 ± 9.4 years old. Tenotomy of the pectoralis minor muscle was performed using axillary approach if it was associated with a first rib resection in 74 cases (90.2%) or through an elective approach in 8 cases (9.8%) if it was isolated. Four (4.9%) postoperative complications were found (1 hematoma [1.2%], 1 hemothorax [1.2%], 1 scapula alata [1.2%], and 1 subclavian vein thrombosis [1.2%]), all after an axillary approach. In 63 cases (79.7%), preoperative symptoms were resolved. In 14 cases (17.7%), symptom resolution was incomplete, and 2 patients (2.6%) had recurrent symptoms. CONCLUSIONS Evaluation of PMCS in TOS is justified by its frequency and the simplicity and low morbidity of the surgical procedure.
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Affiliation(s)
- Myriam Ammi
- Department of Vascular and Thoracic Surgery, University Hospital, Angers, France.
| | - Matthieu Péret
- Department of Vascular and Thoracic Surgery, University Hospital, Angers, France
| | - Samir Henni
- Department of Vascular and Sport Investigations, University Hospital, Angers, France
| | - Mickaël Daligault
- Department of Vascular and Thoracic Surgery, University Hospital, Angers, France
| | - Pierre Abraham
- Department of Vascular and Sport Investigations, University Hospital, Angers, France
| | - Xavier Papon
- Department of Vascular and Thoracic Surgery, University Hospital, Angers, France
| | - Bernard Enon
- Department of Vascular and Thoracic Surgery, University Hospital, Angers, France
| | - Jean Picquet
- Department of Vascular and Thoracic Surgery, University Hospital, Angers, France
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Bussmann A, Heim F, Delay C, Girsowicz E, Del Tatto B, Dion D, Papillon J, Lejay A, Chakfé J, Thaveau F, Georg Y, Chakfé N, Albertini JN, Favre JP, Duprey A, Anidjar S, Battelier J, Chabert S, Chiesa R, Corpataux JM, Deglise S, Daligault M, Picquet J, Sebastian Debus E, David N, Plissonnier D, Favier C, Steinmetz É, Feugier P, Lermusiaux P, Goueffic Y, Kaladji A, Querat J, Guigard S, Magne JL, Hassen-Khodja R, Jean-Baptiste E, Jirari A, Koskas F, Piquet P. Textile Aging Characterization on New Generations of Explanted Commercial Endoprostheses: A Preliminary Study. Eur J Vasc Endovasc Surg 2017; 54:378-386. [DOI: 10.1016/j.ejvs.2017.06.004] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2017] [Accepted: 06/04/2017] [Indexed: 11/26/2022]
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Kassegne T, Ammi M, Thouveny F, Daligault M, Papon X, Enon B, Picquet J. Will Thrombosed Lower Extremities Bypasses Treated with Intra-arterial in Situ Fibrinolysis Keep a Good Secondary Patency? Ann Vasc Surg 2017. [DOI: 10.1016/j.avsg.2016.07.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Augusto JF, Garnier AS, Demiselle J, Langs V, Picquet J, Legall R, Sargentini C, Culty T, Poli C, Ammi M, Ducancelle A, Chevailler A, Duveau A, Subra JF, Sayegh J. Hypogammaglobulinemia and risk of severe infection in kidney transplant recipients. Transpl Infect Dis 2016; 18:741-751. [PMID: 27509578 DOI: 10.1111/tid.12593] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2016] [Revised: 05/30/2016] [Accepted: 06/24/2016] [Indexed: 12/13/2022]
Abstract
BACKGROUND Recent data have outlined a link between hypogammaglobulinemia (HGG) and infection risk and suggested that HGG correction may decrease post-transplant infections. METHODS We analyzed the risk factors of HGG and the relationship between HGG and the risk of severe infection in a cohort of 318 kidney transplant recipients (KTR) who were transplanted between 2003 and 2013. Immunoglobulin (Ig) concentration was measured prospectively at day 15 (D15), month 6 (M6), month 12 (M12), and month 24 (M24) post transplant. RESULTS The prevalence of IgG HGG was 56% and 36.8% at D15 and M6, respectively. Age was the sole identified risk factors for D15 IgG HGG (odds ratio [OR] 1.02, P = 0.019). Risk factors for M6 IgG HGG were the presence of D15 IgG HGG (OR 6.41, P < 0.001) and treatment of acute rejection (OR 2.63, P = 0.014). Most infections occurred between D15 and M6 post transplant. Only age (hazard ratio 1.03, P < 0.001) was identified as a risk factor of infection between D15 and M6 post transplant. Survival free of infection (overall infections and bacterial or viral infections) did not differ significantly between patients with or without D15 IgG HGG. Only septicemia occurring between M6 and M12 post transplant was more frequently observed in patients with HGG. The low prevalence of severe HGG (<400 mg/dL) did not allow conclusions on the infectious risk associated with this patient subgroup. CONCLUSIONS This study does not support the existence of a strong link between post-transplant HGG and the risk of severe infections in KTR. Correction of HGG to minimize the risk of severe infections in KTR is thus questionable and needs to be reevaluated in prospective studies.
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Affiliation(s)
- J-F Augusto
- LUNAM Université, Angers, France. .,Service de Néphrologie-Dialyse-Transplantation, Université Angers, CHU Angers, Angers, France.
| | - A-S Garnier
- LUNAM Université, Angers, France.,Service de Néphrologie-Dialyse-Transplantation, Université Angers, CHU Angers, Angers, France
| | - J Demiselle
- LUNAM Université, Angers, France.,Service de Néphrologie-Dialyse-Transplantation, Université Angers, CHU Angers, Angers, France
| | - V Langs
- LUNAM Université, Angers, France.,Service de Néphrologie-Dialyse-Transplantation, Université Angers, CHU Angers, Angers, France
| | - J Picquet
- LUNAM Université, Angers, France.,Département de Chirurgie Vasculaire, Université Angers, CHU Angers, Angers, France
| | - R Legall
- LUNAM Université, Angers, France.,Département d'Anesthésie et Réanimation, Université Angers, CHU Angers, Angers, France
| | - C Sargentini
- LUNAM Université, Angers, France.,Département d'Anesthésie et Réanimation, Université Angers, CHU Angers, Angers, France
| | - T Culty
- LUNAM Université, Angers, France.,Service d'Urologie, Université Angers, CHU Angers, Angers, France
| | - C Poli
- LUNAM Université, Angers, France.,Laboratoire d'Immunologie, Université d'Angers, CHU Angers, Angers, France
| | - M Ammi
- LUNAM Université, Angers, France.,Département de Chirurgie Vasculaire, Université Angers, CHU Angers, Angers, France
| | - A Ducancelle
- LUNAM Université, Angers, France.,Laboratoire de Virologie, Université d'Angers, CHU Angers, Angers, France
| | - A Chevailler
- LUNAM Université, Angers, France.,Laboratoire d'Immunologie, Université d'Angers, CHU Angers, Angers, France
| | - A Duveau
- LUNAM Université, Angers, France.,Service de Néphrologie-Dialyse-Transplantation, Université Angers, CHU Angers, Angers, France
| | - J-F Subra
- LUNAM Université, Angers, France.,Service de Néphrologie-Dialyse-Transplantation, Université Angers, CHU Angers, Angers, France
| | - J Sayegh
- LUNAM Université, Angers, France.,Service de Néphrologie-Dialyse-Transplantation, Université Angers, CHU Angers, Angers, France
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Jacquinandi V, Bouyé P, Picquet J, Leftheriotis G, Saumet JL, Abraham P. Pain description in patients with isolated proximal (without distal) exercise-related lower limb arterial ischemia. Vasc Med 2016; 9:261-5. [PMID: 15678617 DOI: 10.1191/1358863x04vm560oa] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Among the last 250 claudicants referred to the laboratory for transcutaneous oxygen pressure recording at exercise, we analyzed the symptoms reported by the 36 patients who showed isolated proximal (without distal) ischemia. Among the symptomatic proximal sites cited by these patients, the hip and thigh represent 60%, whereas the buttock is cited in fewer than 25% of cases. Buttock symptoms are reported in only 31% of symptomatic patients. ‘Buttock’ claudication is probably not the dominant symptom in isolated proximal vascular ischemia. Assessing proximal lower limb ischemia through the sole detection of ‘buttock pain’ could contribute to the underestimation of proximal vascular ischemia.
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Affiliation(s)
- Vincent Jacquinandi
- Laboratoire d'explorations vasculaires, Centre Hospitalier Universitaire, Angers, France
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Tesson P, Ammi M, Ghomri D, Daligault M, Péret M, Picquet J. Intra-aortic migration of a Kirschner pin: hybrid surgical repair. J Shoulder Elbow Surg 2016; 25:e281-3. [PMID: 27475454 DOI: 10.1016/j.jse.2016.05.013] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/11/2016] [Accepted: 05/26/2016] [Indexed: 02/01/2023]
Affiliation(s)
- Pierre Tesson
- Vascular and Thoracic Department, University hospital of Angers, Angers, France.
| | - Myriam Ammi
- Vascular and Thoracic Department, University hospital of Angers, Angers, France
| | - Djamel Ghomri
- Orthopaedic Department, Centre Hospitalier de Laval, Laval, France
| | - Mickaël Daligault
- Vascular and Thoracic Department, University hospital of Angers, Angers, France
| | - Matthieu Péret
- Vascular and Thoracic Department, University hospital of Angers, Angers, France
| | - Jean Picquet
- Vascular and Thoracic Department, University hospital of Angers, Angers, France
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43
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Signolet I, Henni S, Colas-Ribas C, Feuilloy M, Picquet J, Abraham P. Prevalence and Causes of Normal Exercise Oximetry in the Calf in Patients with Peripheral Artery Disease and Limiting Calf Claudication. Eur J Vasc Endovasc Surg 2016; 51:572-8. [DOI: 10.1016/j.ejvs.2015.12.040] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2015] [Accepted: 12/22/2015] [Indexed: 11/26/2022]
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44
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Ammi M, Daligault M, Sayegh J, Abraham P, Papon X, Enon B, Picquet J. Evaluation of the Vascular Surgical Complications of Renal Transplantation. Ann Vasc Surg 2016; 33:23-30. [PMID: 26995525 DOI: 10.1016/j.avsg.2016.03.002] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2016] [Revised: 03/01/2016] [Accepted: 03/03/2016] [Indexed: 01/16/2023]
Abstract
BACKGROUND Renal transplantation is the treatment of choice of end-stage renal failure. However, vascular surgical complications can compromise the functional prognosis of the transplant or even be life threatening in the short term. Since few data are available in the literature, the objective of this study was to evaluate the vascular surgical complications of renal transplantation. METHODS In a retrospective and monocentric study, the records of all the patients receiving a kidney transplant between January 2008 and December 2014 were reviewed. The demographic data and the follow-up of the patients who presented a vascular surgical complication in relation to their transplant were collected. Minor, intermediate, or major vascular complications were defined according to the need for monitoring, reoperation, or the risk of transplant loss or a life-threatening situation. Predictive factors of vascular complications were also looked for. RESULTS Mean age was 50.9 ± 15.0 years, and 312 kidney transplants were carried out (205 men). Fifty vascular surgical complications (16.0%) were found. Among them, 23 vascular complications (7.4%) were major, including 6 (1.9%) which required transplantectomy, after 4 arterial thromboses (1.3%), 1 early venous thrombosis (0.3%), and 1 injury of the inferior vena cava (0.3%). Twelve complications (3.8%) were minor. Surgical revision was necessary in 76% of the vascular complications (n = 38). The average follow-up of the transplanted population was 37.4 ± 24.0 month, 268 kidney transplants (85.8%) were functional and 21 patients (6.7%) returned to dialysis. Surgical complications were more frequent when the recipient had hypertension (P = 0.02, OR = 2.5; 95% CI [1.1-6.1]), in case of right kidney transplant (P = 0.0004, OR = 3.1; 95% CI [1.6-5.8]) and when the kidney hilum consisted of at least arteries (P = 0.02, OR = 10.0; 95% CI [1.3-34]). Male gender (P = 0.03, OR = 0.5; 95% CI [0.3-0.9]) as well as the choice of the common iliac arterial (P = 0.001, OR = 0.4; 95% IC [0.2-0.7]) and venous (P = 0.002, OR = 0.3; 95% IC [0.2-0.8]) axes to carry out the vascular anastomoses appeared as protective factors. CONCLUSIONS The vascular surgical complications of kidney transplantation, especially thromboses, can be serious and lead to transplant loss. The expertise of vascular surgeons finds its place here and makes it possible to maintain low rates of vascular complications and loss of transplants.
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Affiliation(s)
- Myriam Ammi
- Service de chirurgie vasculaire, CHU d'Angers, Angers, France; Université de Médecine d'Angers, Angers, France.
| | | | - Jonnhy Sayegh
- Service de néphrologie, CHU d'Angers, Angers, France
| | - Pierre Abraham
- Université de Médecine d'Angers, Angers, France; Service d'explorations fonctionnelles vasculaires, CHU d'Angers, Angers, France; Laboratoire de biologie neurovasculaire et mitochondriale intégrée, UMR INSERM 1083, Angers, France
| | - Xavier Papon
- Service de chirurgie vasculaire, CHU d'Angers, Angers, France; Université de Médecine d'Angers, Angers, France
| | - Bernard Enon
- Service de chirurgie vasculaire, CHU d'Angers, Angers, France; Université de Médecine d'Angers, Angers, France
| | - Jean Picquet
- Service de chirurgie vasculaire, CHU d'Angers, Angers, France; Université de Médecine d'Angers, Angers, France
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Peret M, Ammi M, Daligault M, Papon X, Enon B, Picquet J. The Pectoralis Minor Muscle Syndrome in the Thoracic Outlet. Ann Vasc Surg 2015. [DOI: 10.1016/j.avsg.2015.06.036] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Ammi M, Daligault M, Peret M, Papon X, Enon B, Picquet J. Evaluation of the vascular Surgical Complications of Renal Transplantation. Ann Vasc Surg 2015. [DOI: 10.1016/j.avsg.2015.06.027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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47
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Gouaillier-Vulcain F, Marchand E, Martinez R, Picquet J, Enon B. Utility of Electrofusion for the Femoral Approach in Vascular Surgery: A Randomized Prospective Study. Ann Vasc Surg 2015; 29:801-9. [DOI: 10.1016/j.avsg.2014.09.034] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2014] [Revised: 08/12/2014] [Accepted: 09/09/2014] [Indexed: 12/30/2022]
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Dang Van S, Bournazel V, De Brux JL, Picquet J. Associated aortic coarctation and thoraco-abdominal aneurysm in a 17-year old woman with moderate mitral regurgitation. Eur J Cardiothorac Surg 2015; 49:706. [PMID: 25805892 DOI: 10.1093/ejcts/ezv113] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/06/2015] [Accepted: 02/27/2015] [Indexed: 11/12/2022] Open
Affiliation(s)
- Simon Dang Van
- Department of Cardiovascular and Thoracic Surgery, University Hospital of Angers, Angers, France
| | | | - Jean-Louis De Brux
- Department of Cardiovascular and Thoracic Surgery, University Hospital of Angers, Angers, France
| | - Jean Picquet
- Department of Cardiovascular and Thoracic Surgery, University Hospital of Angers, Angers, France
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Daligault M, Pinaud F, Merlini T, Picquet J. Endovascular treatment of iatrogenic aortic graft injury after sternal puncture. Eur J Cardiothorac Surg 2015; 47:e226-8. [PMID: 25661077 DOI: 10.1093/ejcts/ezv036] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/10/2014] [Accepted: 01/14/2015] [Indexed: 11/14/2022] Open
Abstract
We report the case of a 71-year old woman who had previously undergone supra-aortic trunk transposition via a median sternotomy, along with endovascular thoracic aortic stent-graft repair. During the diagnostic sternal puncture for a recently discovered acute lymphoblastic leukaemia, an accidental graft injury occurred. For this patient, who was not a surgical candidate, endovascular treatment with a covered stent (endograft) was performed, with uneventful postoperative follow-up. This case report illustrates the limitations of sternal puncture in patients with a previous sternotomy, and discusses the possibility of endovascular treatment in the event of aortic graft injury, given easy accessibility and favourable aortic neck anatomy.
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Affiliation(s)
- Mickael Daligault
- Department of Cardio-Vascular Surgery, University Hospital of Angers, Angers, France
| | - Frédéric Pinaud
- Department of Cardio-Vascular Surgery, University Hospital of Angers, Angers, France CNRS UMR 6214, INSERM 1083, University of Angers, Angers, France
| | - Thierry Merlini
- Department of Cardio-Vascular Surgery, University Hospital of Angers, Angers, France
| | - Jean Picquet
- Department of Cardio-Vascular Surgery, University Hospital of Angers, Angers, France
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Congnard F, Bruneau A, Abraham P, Colas-Ribas C, Picquet J, Noury-Desvaux B. Time and reliability issues associated with automatic vs. manual measurements of Ankle to Brachial pressure Index (ABI) following heavy load exercise. J Sci Med Sport 2014; 18:737-41. [PMID: 25465348 DOI: 10.1016/j.jsams.2014.10.007] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2014] [Revised: 10/13/2014] [Accepted: 10/21/2014] [Indexed: 11/17/2022]
Abstract
OBJECTIVES Ankle to brachial index after heavy load exercise is the most accurate way of diagnosing minor arterial lesions in athletes, such as endofibrosis. The reliability and practical aspects of ankle to brachial index measurements after heavy-load exercise have not been studied. The purpose of this study was to analyze the interest of oscillometric automatic vs. manual Doppler measurements, for the calculation of ankle to brachial index, after heavy-load exercise in athletes. DESIGN Prospective single-center study. METHODS Fifteen healthy trained athletes performed an incremental test twice. Ankle to brachial index measurements were performed at Rest, as soon as possible after exercise (Rec-0), and then started at the 3rd minute of recovery (Rec-3), by two operators using each one of the two ankle to brachial index measurement methods. RESULTS Mean times for automatic vs. manual ankle to brachial availability were 99 ± 18 s vs. 113 ± 25 s (p = 0.005) and 44 ± 25 s vs. 53 ± 12 s (p = 0.001) respectively at Rec-0 and Rec-3. Ankle to brachial index values from the two methods were highly correlated (r = 0.89). Mean absolute differences of automatic vs. manual ankle to brachial values from test-retest were 0.04 ± 0.05 vs. 0.08 ± 0.08 (p > 0.05) and 0.07 ± 0.05 vs. 0.09 ± 0.10 (p > 0.05) at Rest and Rec-0. CONCLUSIONS Automatic method allows obtaining faster and simultaneously post-exercise ankle to brachial index measurement compare to the manual Doppler. This time issue does not result in a significant change in absolute ankle to brachial index values, nor in the absolute differences of these in test-retest. Nevertheless, the test-retest variability of post-exercise ankle to brachial index results seems smaller with the automatic than the manual method.
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Affiliation(s)
- Florian Congnard
- Physical Activity and Sport Learning Institute (IFEPSA), Angers, France
| | - Antoine Bruneau
- Laboratory for Sport and Vascular Investigation, University Hospital of Angers, France
| | - Pierre Abraham
- Laboratory for Sport and Vascular Investigation, University Hospital of Angers, France; UMR INSERM 1083 CNRS6214, University of Medicine, Angers, France.
| | | | - Jean Picquet
- UMR INSERM 1083 CNRS6214, University of Medicine, Angers, France; Department of Thoracic and Cardiovascular Surgery, University Hospital of Angers, France
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